Employer Industry: Pharmacy Benefit Management

Why consider this job opportunity:
- Annual salary up to $29,000 plus benefits
- Comprehensive benefits package including health insurance, life insurance, gym reimbursement, and a 401K plan
- Opportunity for performance bonuses and a Christmas bonus
- Work in a collaborative and innovative environment focused on patient-centric care
- Potential for professional growth and development within the organization
- Open to newly licensed technicians, providing a supportive entry into the field

What to Expect (Job Responsibilities):
- Review claim activity against benefit setups to ensure accurate processing according to client-approved requirements
- Prepare test grids and execute manual and batch testing in UAT and Production/Live environments
- Troubleshoot and resolve reported claim defects related to adjudication, payments, and denials
- Proactively identify potential issues impacting claim processing and develop solutions
- Organize and document findings and results in a standardized client-facing format

What is Required (Qualifications):
- Minimum of 1 year of experience in a medical, insurance, or pharmacy claims environment
- Proficiency in Microsoft Office applications, particularly Word and Excel
- Excellent verbal and written communication skills, with the ability to tailor communication to the audience
- Strong organizational and time management skills
- Current, valid, and unrestricted state or Puerto Rico Pharmacy Technician license/registry certificate

How to Stand Out (Preferred Qualifications):
- 1-2 years of clinical experience in a healthcare environment or at a pharmacy benefit manager (PBM)
- Pharmacy claims experience and quality and claims audit experience
- Bilingual in English and Spanish
- Nationally Certified Pharmacy Technician (CPhT) certification
- Knowledge of pharmacy terminology

#PharmacyBenefitManagement #HealthcareCareers #ClaimsValidation #CompetitiveBenefits #ProfessionalGrowth

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.